Brief Answer:
? Pompholyx/ ? Allergic contact dermatitis

Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand from your query that you are having rashes and bumps on your trunk along with some bumps on your fingers.
I have seen your the 4 images you have uploaded. But all the images seem to be the same( showing the lesions on your fingers)
The possibilities I would consider for the bumps on your fingers are Pompholyx and Allergic contact dermatitis.

Pompholyx is a type of allergy which occurs without any obvious cause. It could go away and relapse again, usually in the same seasons every year. It is more common in people who have a tendency for allergies ( nasal allergies, asthma, etc).
You could apply a cream containing 1 % hydrocortisone twice a day for 2 weeks.

The other possibility is Allergic contact dermatitis. This occurs after an exposure to an external allergen like gloves, plants like marigold, lilies, etc and cosmetics. Have you been exposed to any allergen before the onset of rashes?
The treatment involves avoiding the potential allergen. You could use the same cream as mentioned above to get symptomatic relief.

Please upload the pictures of the bumps on your back and trunk so I can asses them as well.

Please revert with additional details.

Regards,
Dr. Johny Chacko

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Brief Answer:
Scabies

Detailed Answer:
Hello,
Thank you for uploading the pictures.

After seeing the lesions on your trunk and arms and also considering the lesions on your fingers, I would like to revise my earlier diagnosis. I would consider the diagnosis of Scabies.

Scabies is an infestation caused by a mite. It is contagious and spreads from person to person. The mite tends to remain in the clothes and the bedding and can re infest again.

You need to do the following treatment -
1. 5% Pemithrin cream - This cream has to be used as a single overnight application all over your body. Have a hot water bath, apply the contents of an entire tube from the neck below ( including the areas where the lesions are not present too, the nail beds, genitalia). Keep the cream overnight and wash off in th e morning. This has to be done only 1 night and not everyday.

2. You need to wash all your clothes which you have used in the past 3 days and also your bedding to get rid of the mites which could reside in them.

3. You could also take an antihistamine like Benadryl at bedtime for symptomatic relief of itching for 2 weeks. The itching tends to persist for 2-3 weeks even after the mites are destroyed by step 1. This is because the body would have developed a mild allergy to the dead mite products. You will therfore need to take an antihistamine.

4. Apply a cream containing 1% fusidic acid twice a day on all the lesions for 2 weeks for the lesions to heal. Start this the day after you apply permethrin.

Hope this helps you.

Take care.
Regards,

Dr. Johny Chacko

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Brief Answer:
Scabies management

Detailed Answer:
Hello,
The lesions in the pictures you have uploaded seem to be crusted / healing. They do not look like they are actively infected. That is the reason I asked you to use permethrin initially followed by a topical antibiotic (1% Fusidic acid cream) on the lesions alone, to completely heal them.

However, if you have any lesions discharging pus, I suggest that you start on an oral antibiotic like Amoxycillin or Cephalexin for 5 days. Start the topicals/ creams 2 days after you have started the oral antibiotic. The same regime can be followed for the application.

Allergy to permethrin is rare. You might develop itchy hives or blotchy rashes on the areas of application if you do happen to have an allergy to it.

Hope this clears your doubt.

Regards,
Dr. Johny Chacko

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Brief Answer:
Scabies with secondary infection

Detailed Answer:
Hello,
I have seen the new clinical picture that you have uploaded.

The lesions in the picture look infected. That is the reason you are having a discharge.

In my opinion, skin infection alone will not be itchy. There is definitely an underlying itchy dermatoses which is getting infected secondarily due to scratching. I still feel it could be scabies based on the morphology of lesions on your fingers and trunk.

In many cases, since scabies cannot be established by doing any laboratory tests, we give the patient empirical treatment of scabies. This is done because scabies treatment is relatively safe, has no major side effects and involves just a single application of the anti-scabies cream which is convenient.

However, looking at your current lesions, I feel that you should take the course of antibiotics initially for 2- 3 days and apply the anti- scabies cream after the lesions have dried up.

It is advisable to wash the clothes and beddings that you have used for the last 3 days as I have mentioned earlier.

Hope this clears your doubt.

Take care,
Dr. Johny Chacko

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